Provider Demographics
NPI:1821559899
Name:TAYLOR, JOSHUA C (DO)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:C
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3250 W LAKE RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16505-3691
Mailing Address - Country:US
Mailing Address - Phone:814-790-4567
Mailing Address - Fax:814-295-4074
Practice Address - Street 1:3250 W LAKE RD
Practice Address - Street 2:SUITE 2
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16505-3691
Practice Address - Country:US
Practice Address - Phone:814-790-4567
Practice Address - Fax:814-295-4074
Is Sole Proprietor?:No
Enumeration Date:2019-03-30
Last Update Date:2023-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
PAOS0229362084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program